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AARP Medicare Advantage from UHC WA-12 (PPO)

H2001 - 087 - 0
4 out of 5 stars (4 / 5)

AARP Medicare Advantage from UHC WA-12 (PPO) is a Medicare Advantage Plan by UnitedHealthcare.

This page features plan details for 2025 AARP Medicare Advantage from UHC WA-12 (PPO) H2001 – 087 – 0 available in Select counties in Washington.

Locations

AARP Medicare Advantage from UHC WA-12 (PPO) is offered in the following locations.

Benton County, Washington
Clallam County, Washington
Clark County, Washington

Click to see more locations

Plan Overview

AARP Medicare Advantage from UHC WA-12 (PPO) offers the following coverage and cost-sharing.

Insurer:UnitedHealthcare
Health Plan Deductible:$0
MOOP:$10,100 In and Out-of-network
$6,700 In-network
Drugs Covered:Yes

Ready to sign up for AARP Medicare Advantage from UHC WA-12 (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Premium Breakdown

AARP Medicare Advantage from UHC WA-12 (PPO) has a monthly premium of $0.00. This amount includes your Part C and D premiums but does not include your Part B premium. The following is a breakdown of your monthly premium with Part B costs included.
Part B Part C Part D Part B Give Back Total
$185.00 $0.00 $0.00 $ $
Please Note:
  • Your Part B premium may differ based on factors including late enrollment, income, and disability status.
  • You may also qualify for “Extra Help” on drug costs. See the Part D Premium Reduction section below for more details.

Drug Info

AARP Medicare Advantage from UHC WA-12 (PPO) provides the following cost-sharing on drugs. Please check the plan’s formulary for specific drugs covered.

Drug Deductible: $420.00
Drug Out-Of-Pocket maximum: $2,000.00
Drug Benefit Type: Enhanced Alternative

Part D Premium Reduction

The Low-Income Subsidy (also known as LIS or “Extra Help”) helps people with Medicare lower the cost of prescription drugs.

The table below shows how the LIS impacts the Part D premium of this plan.

Part DLIS Full
$0.00$0.00

Initial Coverage Phase

After you pay your $420.00 drug deductible, you will pay the following costs for drugs in each tier until your total drug costs (including what this plan has paid and what you have paid) reach $2,000.00. Once you reach that amount, you will enter the next coverage phase.

Catastrophic Coverage Phase

After your yearly out-of-pocket drug costs (including drugs purchased through your retail pharmacy and through mail order) reach $2,000.00, you pay nothing for Medicare Part D covered drugs. However, you may still pay a share of the costs for excluded drugs covered under any enhanced benefit. Please note, that this plan has a Enhanced Alternative benefit type.

Additional Benefits

AARP Medicare Advantage from UHC WA-12 (PPO) also provides the following benefits.

Additional benefits and/or reduced cost-sharing for enrollees with certain health conditions?

    • In-Network: No

Comprehensive Dental

  • Adjunctive General Services
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Endodontics
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Maxillofacial Prosthetics
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Maxillofacial Prosthetics
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
  • Oral and Maxillofacial Surgery
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Periodontics
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)
  • Prosthodontics, fixed
    • In-Network: 0-50 Coins – No Co pay (Authorization Required)
  • Prosthodontics, removable
    • In-Network: 0-50 Coins – No Co pay (Authorization Required)
  • Restorative Services
    • In-Network: No Coins – 0.00 Copay (Authorization Required)
    • Out-of-Network: No Coins – 0.00 Copay (Authorization Required)

Diagnostic and Preventive Dental

  • Dental X-Rays
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay
  • Fluoride Treatment
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay
  • Oral Exams
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay
  • Other Diagnostic Dental Services
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay
  • Other Preventive Dental Services
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay
  • Prophylaxis (cleaning)
    • In-Network: No Coins – 0.00 Copay
    • Out-of-Network: No Coins – 0.00 Copay

Diagnostic procedures/lab services/imaging

  • Diagnostic radiology services (e.g., MRI)
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Lab services
    • In-Network: $0 copay (Authorization Required)
  • Diagnostic radiology services (e.g., MRI)
    • In-Network: $0-170 copay (Authorization Required)
  • Diagnostic tests and procedures
    • In-Network: $40 copay (Authorization Required)
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Lab services
    • Out-of-Network: $0 copay (Authorization Required)
  • Outpatient x-rays
    • In-Network: $25 copay (Authorization Required)
    • Out-of-Network: $40 copay (Authorization Required)

Doctor visits

  • Primary
    • In-Network: $0 copay
  • Specialist
    • In-Network: $0-45 copay per visit (Authorization Required)
    • Out-of-Network: $70 copay per visit (Authorization Required)
  • Primary
    • Out-of-Network: $25 copay per visit

Emergency care/Urgent care

  • Emergency
    • $125 copay per visit (always covered)
  • Urgent care
    • $0-45 copay per visit (always covered)

Foot care (podiatry services)

  • Foot exams and treatment
    • Out-of-Network: $70 copay (Authorization Required)
  • Routine foot care
    • In-Network: $40 copay (Limits Apply, Authorization Required)
  • Foot exams and treatment
    • In-Network: $40 copay (Authorization Required)

Ground ambulance

    • In-Network: $290 copay
    • Out-of-Network: $290 copay

Health plan deductible

    • $0

Hearing

  • Hearing aids
    • Out-of-Network: $199-1,249 copay (Limits Apply, Authorization Required)
  • Medicare-Covered Hearing Exam
    • Out-of-Network: $70 copay (Authorization Required)
  • Hearing aids OTC
    • In-Network: $99-829 copay (Limits Apply)
  • Medicare-Covered Hearing Exam
    • In-Network: $0 copay (Authorization Required)
  • Fitting/evaluation
    • Not covered
  • Hearing aids
    • In-Network: $199-1,249 copay (Limits Apply, Authorization Required)
  • Hearing aids OTC
    • Out-of-Network: $99-829 copay (Limits Apply)

Inpatient hospital coverage

    • In-Network: $390 per day for days 1 through 5
      $0 per day for days 6 through 90
      $0 per day for days 91 and beyond (Authorization Required)
    • Out-of-Network: $595 per day for days 1 through 17
      $0 per day for days 18 and beyond (Authorization Required)

Maximum out-of-pocket enrollee responsibility (does not include prescription drugs)

    • $10,100 In and Out-of-network
      $6,700 In-network

Medical equipment/supplies

  • Diabetes supplies
    • In-Network: $0 copay per item (Authorization Required)
    • Out-of-Network: 50% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • In-Network: 20% coinsurance per item (Authorization Required)
  • Durable medical equipment (e.g., wheelchairs, oxygen)
    • In-Network: 20% coinsurance per item (Authorization Required)
    • Out-of-Network: 50% coinsurance per item (Authorization Required)
  • Prosthetics (e.g., braces, artificial limbs)
    • Out-of-Network: 50% coinsurance per item (Authorization Required)

Medicare Part B drugs

  • Other Part B drugs
    • Out-of-Network: 0-30% coinsurance (Authorization Required)
  • Chemotherapy
    • Out-of-Network: 30% coinsurance (Authorization Required)
  • Other Part B drugs
    • In-Network: 0-20% coinsurance (Authorization Required)
  • Chemotherapy
    • In-Network: 0-20% coinsurance (Authorization Required)

Mental health services

  • Outpatient group therapy visit
    • Out-of-Network: $30 copay (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • Out-of-Network: $30 copay (Authorization Required)
  • Outpatient individual therapy visit
    • In-Network: $0-25 copay (Authorization Required)
    • Out-of-Network: $40 copay (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • In-Network: $0-25 copay (Authorization Required)
  • Outpatient group therapy visit
    • In-Network: $15 copay (Authorization Required)
  • Outpatient individual therapy visit with a psychiatrist
    • Out-of-Network: $40 copay (Authorization Required)
  • Inpatient hospital – psychiatric
    • In-Network: $390 per day for days 1 through 4
      $0 per day for days 5 through 90 (Authorization Required)
    • Out-of-Network: $595 per day for days 1 through 17
      $0 per day for days 18 through 90 (Authorization Required)
  • Outpatient group therapy visit with a psychiatrist
    • In-Network: $15 copay (Authorization Required)

Optional supplemental benefits

    • Yes

Other health plan deductibles?

    • In-Network: No

Outpatient hospital coverage

    • In-Network: $0-390 copay per visit (Authorization Required)
    • Out-of-Network: $595 copay per visit (Authorization Required)

Preventive care

    • In-Network: $0 copay
    • Out-of-Network: 0-30% coinsurance

Rehabilitation services

  • Physical therapy and speech and language therapy visit
    • Out-of-Network: $70 copay (Authorization Required)
  • Occupational therapy visit
    • In-Network: $0-45 copay (Authorization Required)
  • Physical therapy and speech and language therapy visit
    • In-Network: $0-50 copay (Authorization Required)
  • Occupational therapy visit
    • Out-of-Network: $70 copay (Authorization Required)

Skilled Nursing Facility

    • In-Network: $0 per day for days 1 through 20
      $203 per day for days 21 through 100 (Authorization Required)
    • Out-of-Network: $225 per day for days 1 through 100 (Authorization Required)

Transportation

    • Not covered

Vision

  • Eyeglass lenses
    • In-Network: $0-153 copay (Limits Apply)
  • Eyeglasses (frames and lenses)
    • Not covered
  • Contact lenses
    • Out-of-Network: $0-153 copay (Limits Apply)
  • Eyeglass frames
    • In-Network: $0 copay (Limits Apply)
    • Out-of-Network: $0-153 copay (Limits Apply)
  • Eyeglass lenses
    • Out-of-Network: $0-153 copay (Limits Apply)
  • Other
    • Not covered
  • Routine eye exam
    • In-Network: $0 copay (Limits Apply, Authorization Required)
  • Upgrades
    • Not covered
  • Contact lenses
    • In-Network: $0 copay (Limits Apply)
  • Routine eye exam
    • Out-of-Network: $70 copay (Limits Apply, Authorization Required)

Wellness programs (e.g., fitness, nursing hotline)

    • Covered

Dental Platinum Rider

Comprehensive Dental

  • Restorative Services, Endodontics, Periodontics, Prosthodontics, removable, Maxillofacial Prosthetics, Prosthodontics, fixed, Oral and Maxillofacial Surgery, Adjunctive General Services
    • Monthly Premium: $46.00

Diagnostic and Preventive Dental

  • Oral Exams, Dental X-Rays, Other Diagnostic Dental Services, Prophylaxis (Cleaning), Fluoride Treatment, Other Preventive Dental Services
    • Monthly Premium: $46.00

Ready to sign up for AARP Medicare Advantage from UHC WA-12 (PPO) ?

Get help from a licensed insurance agent.

Call 1-877-354-4611 / TTY 711.

M-F: 8:00 am – 10:00 pm EST

Sat-Sun: 8:00 am – 9:00 pm EST

Table of Contents

Get Help Enrolling

Get help enrolling in a Medicare Advantage or Medicare Prescription Drug Plan by calling a licensed insurance agent today.

Medicare Advantage and Part D plans and benefits offered by the following carriers: Aetna Medicare, Anthem Blue Cross Blue Shield, Anthem Blue Cross, Aspire Health Plan, Capital Blue Cross, Cigna Healthcare, Dean Health Plan, Devoted Health, Florida Blue Medicare, GlobalHealth, Health Care Service Corporation, Healthy Blue, Humana, Molina Healthcare, Mutual of Omaha, Premera Blue Cross, Medica Central Health Plan, SCAN Health Plan, Baylor Scott & White Health Plan, Simply, UnitedHealthcare(R), Wellcare, WellPoint

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Part B premium reduction is not available with all plans. Availability varies by carrier and location. Actual Part B premium reduction could be lower. Deductibles, copays and coinsurance may apply.

All plan-related information on this site is from CMS.gov and Medicare.gov. We only use data released publicly each year. While our goal is always to provide fact-based, accurate information, information is subject to change, and some data may be inaccurate. Contact a plan for a Summary of Benefits.

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We do not offer every plan available in your area. Currently, we represent 18 organizations, which offer 52,101 products in your area. Please contact Medicare.gov, 1-800-MEDICARE, or your local State Health Insurance Program (SHIP) to get information on all of your options.

We represent Medicare Advantage HMO, PPO and PFFS organizations and stand-alone PDP prescription drug plans that are contracted with Medicare. Enrollment depends on the plan’s contract renewal.

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